title: Unilateral posterior cervical spinal cord infarction due to spontaneous vertebral artery dissection.
abstract: BACKGROUND
  Ischemia of the cervical spinal cord is a rare complication of spontaneous vertebral artery dissection (VAD) and usually involves the ventral portion. We describe a less evocative clinical presentation and images of unilateral posterior spinal cord infarction due to spontaneous VAD in order to facilitate early diagnosis.
  
  
  RESULTS
  A previously fit 30-year-old man presented with persistent headaches and proximal motor deficit of the right arm. He was diagnosed with spontaneous dissection of both vertebral arteries, with occlusion of the right one, and the right carotid artery. Neurological examination also revealed a right C2-C3 tactile sensory loss, with unilateral proprioceptive deficit below. Brain images revealed small bilateral cerebellar infarcts which could not be responsible for the clinical symptoms. Magnetic resonance imaging of the spinal cord showed a right posterior cervical spinal cord infarction. The patient achieved nearly complete recovery after several weeks of anticoagulation and rehabilitation.
  
  
  CONCLUSIONS
  Infarction of the caudal portion of the cervical spinal cord, especially unilateral, caused by spontaneous VAD, has rarely been described and is certainly under-diagnosed due to less suggestive symptoms, like unilateral and mainly sensory deficit. Nevertheless, early diagnosis of this condition is important to guide patient management and rehabilitation.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Richard
authors.forename: Chifaou
authors.initials: C
authors.lastname: Abdallah
authors.forename: Anne
authors.initials: A
authors.lastname: Chanson
authors.forename: Sylvain
authors.initials: S
authors.lastname: Foscolo
authors.forename: Pierre-Alexandre
authors.initials: PA
authors.lastname: Baillot
authors.forename: Xavier
authors.initials: X
authors.lastname: Ducrocq
mesh_terms: D000328:Adult; D020520:Brain Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D064847:Multimodal Imaging; D020760:Spinal Cord Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D014057:Tomography, X-Ray Computed; D020217:Vertebral Artery Dissection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy
keywords: Cervical arterial dissection; Cervical spinal cord infarction; Posterior spinal cord; Vertebral artery